The far-east Victorian coastal township of Mallacoota faces an ongoing battle with the recruitment and retention of GPs and urgent care medical staff.
Since the Black Summer bushfires of 2019, the town has benefited from services of three GPs and a paramedic roster of first-aid-trained ambulance officers after a dedicated recruitment campaign.
"We're a small practice and a small community ... we're always one doctor away from a workforce crisis," said Sara Renwick-Lau, a GP who has worked in the town for the past 15 years.
"Unfortunately, in July, when we lose our third doctor, we're going to be halving our ability to provide appointments for patients. Keeping the practice open five days a week is going to become much more of a challenge."
The looming pressures on the town's medical staff have only been compounded by the uncertain future of the town's paramedic roster.
An ongoing administrative predicament
Much of Mallacoota's historic health service predicament comes down to the district not being part of a regional health network, a long-standing administrative anomaly that has compromised the town's eligibility for state funding and resources.
"Mallacoota is a little bit different to most towns in Victoria in that we have an ambulance station, a general practice but no hospital – and until recently we didn't have a permanent paramedic," Dr Renwick-Lau said.
"We don't belong to any state funded regional health service."
With an ageing population and visitor numbers that can swell to 8,000 over the summer, the situation can be precarious at times, with the closest 24-hour emergency departments a two-hour drive to Orbost or Bega.
Attracting health professionals to rural areas
With the COVID-19 pandemic exacerbating pre-existing exhaustion, burnout and fatigue experienced within Australia's medical workforce, Dr Renwick-Lau said it was surprising that more doctors were not looking for a sea change.
"I don't know why GPs would like to work in the city ... a lot of doctors don't want to move to small remote areas ... and the pool of doctors in Australia who are willing to work in the bush is very small, so there are a lot of places obviously that need those doctors."
But Dr Renwick-Lau said the promise of gaining more of a work-life balance, could quickly become skewed towards overwork and overwhelm for a lone, on-call doctor servicing a remote area.
She said it was a constant worry knowing that if she took a sick day, the nearest 24/7 urgent care service was a two-hour drive to Orbost or Bega.
Dr Renwick-Lau said she believed attracting and retaining doctors and medical professions in rural areas came down to asking and accommodating what may make the position sustainable for applicants in the long term.
More nurses needed to cover urgent care needs
Dr Renwick-Lau said a coordinated approach could provide an around-the-clock medical service in Mallacoota, using the skills of people physically living in the town combined with the expertise of allied health professionals.
"If I was looking towards a solution, I'd be looking at employing a handful of nurses to provide a triage service between 6pm and 8am and on weekends," she said.
She said an around-the-clock roster would require at least six nurses to operate effectively and deal with everything from broken arms to cardiac arrests and dispensing antibiotics.
"I don't think we need necessarily a hospital or a super clinic, I think a little bit of state heath support would go a long way", she said of the need to co-ordinate a system between allied health professionals and medical resources in the town.
"As a local GP I'd really like to liaise with nurses and paramedics and with emergency doctors to provide the right care at the right place at the right time. I think we can easily do that."
